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Osteoarthritis and Exercise

Recommendations for Exercise with OA

All patients with arthritis should see their doctor for a careful history and physical examination before beginning an exercise program. When beginning an exercise program, joint protection is very important for persons with OA. Be careful not to overstretch lax joints, and when joint pain and swelling follow activity, they should be treated as an "overuse" injury, with ice and rest. Steps should be taken to strengthen the joint in preparation to return to an activity. On days when the disease flares in one or a few joints, it is possible to alternate activities so the exercise habit is maintained, but joints are protected. Weight bearing should be no longer than 2-4 hours and should be followed by 1 hour of non-weight bearing.

It is important to recognize the difference between exercise to improve general health and exercising for physical fitness. It is not necessary for a person to participate in a high intensity exercise program or attain high levels of fitness to improve health status. Adopting a low intensity but regular activity significantly decreases risks for a number of diseases such as chronic heart disease and osteoporosis.

These two different types of exercise are explained below.

Physical Activity for Health Benefits

Purpose: establish a habit of regular physical activity to promote health.

Mode: aerobic activity.
Frequency: most days of the week.
Intensity: 50-70% MHR. (Maximal Heart Rate = 220 minus age.)
Duration: 30 minutes accumulation of moderate activity during the day.

Exercise Training for Physical Fitness

Purpose: increase cardiovascular and muscular fitness through regular physiologic overload.

1. Exercise training for cardiovascular fitness

Mode: aerobic activity.
Frequency: 3-5 days of the week.
Intensity: 60-80% MHR.
Duration: 20-60 minutes continuous.

2. Exercise training for muscular fitness (strength and endurance).

Mode: Resistance exercise (free weights or machines, especially knee strengthening.
Frequency: 2-3 days/week.
Volume: 8-10 exercises; 8-12 lifts of a load that can be lifted correctly and produce local fatigue in 8-12 repetitions; 1-3 sets as tolerated.

3. Range of motion exercise for improved mobility.

Mode: gentle stretching, range of motion.
Frequency: daily, should encompass the whole body.